EP2537528B1 - Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease - Google Patents

Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease Download PDF

Info

Publication number
EP2537528B1
EP2537528B1 EP12172907.3A EP12172907A EP2537528B1 EP 2537528 B1 EP2537528 B1 EP 2537528B1 EP 12172907 A EP12172907 A EP 12172907A EP 2537528 B1 EP2537528 B1 EP 2537528B1
Authority
EP
European Patent Office
Prior art keywords
galactosidase
treatment
reflux disease
gastroesophageal reflux
compositions containing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP12172907.3A
Other languages
German (de)
French (fr)
Other versions
EP2537528A1 (en
Inventor
Alessandro Zanarotti
Gabriele Brunetti
Sergio Cecchetti
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Alfa Wasserman SpA
Original Assignee
Alfa Wasserman SpA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Alfa Wasserman SpA filed Critical Alfa Wasserman SpA
Priority to MEP-2015-159A priority Critical patent/ME02285B/en
Priority to PL12172907T priority patent/PL2537528T3/en
Priority to SI201230335T priority patent/SI2537528T1/en
Publication of EP2537528A1 publication Critical patent/EP2537528A1/en
Application granted granted Critical
Publication of EP2537528B1 publication Critical patent/EP2537528B1/en
Priority to HRP20151082TT priority patent/HRP20151082T1/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/47—Hydrolases (3) acting on glycosyl compounds (3.2), e.g. cellulases, lactases
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N9/00—Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/14—Hydrolases (3)
    • C12N9/24—Hydrolases (3) acting on glycosyl compounds (3.2)
    • C12N9/2402—Hydrolases (3) acting on glycosyl compounds (3.2) hydrolysing O- and S- glycosyl compounds (3.2.1)
    • C12N9/2465—Hydrolases (3) acting on glycosyl compounds (3.2) hydrolysing O- and S- glycosyl compounds (3.2.1) acting on alpha-galactose-glycoside bonds, e.g. alpha-galactosidase (3.2.1.22)

Definitions

  • the present invention relates to pharmaceutical or nutritional compositions containing ⁇ -galactosidase and ⁇ -galactosidase. Said compositions are useful in the prevention and/or treatment of gastroesophageal reflux disease.
  • GORD gastro-oesophageal reflux disease
  • Reflux of the stomach contents into the oesophagus is a physiological phenomenon; when the frequency of the episodes increases, the reflux becomes harmful to the oesophageal mucosa and causes the appearance of symptoms and complications, such as oesophagitis and Barrett's oesophagus.
  • the treatment is based on suppression of the acid secretion.
  • PPIs therefore represent the first-choice treatment in GERD.
  • H2 antihistamines (anti-H2s) and antacids are also used to treat the symptoms of gastroesophageal reflux disease.
  • lactose increases acid reflux episodes and markedly influences the function of the lower oesophageal sphincter.
  • the effects of lactose are mediated by the production of short-chain fatty acids, which derive from the metabolism of lactose by the bacterial flora of the colon ( Piche et al., 2000; Am J Physiol Gastrointest Liver Physiol 278: G578-84 ).
  • fructo-oligosaccharides also induces effects on the pressure of the lower oesophageal sphincter and the pH of the oesophageal lumen similar to those observed with lactose administration ( Piche et al., Gastroenterology 2003; 124: 894-902 ).
  • the present invention relates to pharmaceutical or nutritional compositions containing ⁇ -galactosidase and ⁇ -galactosidase.
  • the invention also relates to the use of said compositions in the prevention and/or treatment of gastroesophageal reflux disease.
  • the present invention relates to pharmaceutical or nutritional compositions containing ⁇ -galactosidase and ⁇ -galactosidase as active ingredients.
  • compositions containing ⁇ -galactosidase and ⁇ -galactosidase are useful in the prevention and/or treatment of gastroesophageal reflux disease (GERD).
  • Said compositions have a different action mechanism from those of the medicaments currently used (acid secretion inhibitors) in that they inhibit reflux or at least reduce its frequency.
  • the present invention represents a new therapeutic strategy, which is designed in particular for non-responders and patients with a poor response to the current treatments based on proton pump inhibitors.
  • compositions to which the present invention relates can be also added to the existing treatments (as an "add-on therapy"), leading to a significant improvement in the quality of life of many patients with gastroesophageal reflux disease.
  • the present invention relates to pharmaceutical or nutritional compositions containing a combination of the active ingredients, mixed with at least one pharmaceutically acceptable excipient or carrier.
  • compositions are preferably administered orally.
  • compositions for the prevention and/or treatment of gastroesophageal reflux disease containing ⁇ -galactosidase and ⁇ -galactosidase as active ingredients can be formulated by conventional methods.
  • the preferable dosage forms are solid formulations for oral administration, such as powders, granules, tablets, pills and capsules.
  • the active ingredients can be mixed with at least one pharmaceutically acceptable excipient or carrier, such as an inert diluent, a lubricant such as magnesium stearate, an anti-caking agent such silicon dioxide, a preservative, an antioxidant, a disintegrant, a binder, a thickening agent, a buffer, a sweetener such as acesulfame potassium, a flavouring agent, etc..
  • a pharmaceutically acceptable excipient or carrier such as an inert diluent, a lubricant such as magnesium stearate, an anti-caking agent such silicon dioxide, a preservative, an antioxidant, a disintegrant, a binder, a thickening agent, a buffer, a sweetener such as acesulfame potassium, a flavouring agent, etc.
  • Further dosage forms can be liquid formulations for oral administration including, for example, emulsions, syrups, elixirs, suspensions and solutions.
  • the dose of the active ingredients for each patient is determined on the basis of age, body weight, general state of health, gender, diet, condition of the disease treated and/or other factors.
  • the quantity of the active ingredients in the composition can range from 75 GalU to 2400 GalU for ⁇ -galactosidase, preferably from 300 GalU to 1200 GalU, and most preferably amounts to 300 GalU in the form of dosage units, and from 2500 to 12500 LactU for ⁇ -galactosidase, preferably from 3500 to 11000 LactU, and most preferably amounts to 4500 LactU in the form of dosage units.
  • the dosage unit form is usually administered one or more times a day, as required.
  • ⁇ -Galactosidase has proved to prevent the onset of bloating and flatulence symptoms after intake of Non-digestible Oligosaccharides (NDOs) and to reduce the intensity of heartburn and the frequency of regurgitation episodes during repeated administration to patients with gastroesophageal reflux disease.
  • NDOs Non-digestible Oligosaccharides
  • composition according to the invention in the form of a tablet to be swallowed or chewed contains:
  • composition according to the invention in the form of a tablet to be swallowed contains:

Description

    Field of invention
  • The present invention relates to pharmaceutical or nutritional compositions containing α-galactosidase and β-galactosidase. Said compositions are useful in the prevention and/or treatment of gastroesophageal reflux disease.
    • State of the art
  • Gastroesophageal reflux disease (GERD), also known as gastro-oesophageal reflux disease (GORD), arises when the stomach contents flow back into the oesophagus.
  • It is an extremely common disorder, characterised by heartburn and regurgitation.
  • Reflux of the stomach contents into the oesophagus is a physiological phenomenon; when the frequency of the episodes increases, the reflux becomes harmful to the oesophageal mucosa and causes the appearance of symptoms and complications, such as oesophagitis and Barrett's oesophagus.
  • As the most harmful constituent of reflux is hydrochloric acid, the treatment is based on suppression of the acid secretion.
  • The treatment of GERD greatly improved with the advent of proton pump inhibitors (PPIs), which lead to (endoscopic) healing of oesophagitis in over 90% of cases.
  • PPIs therefore represent the first-choice treatment in GERD.
  • However, although PPIs reduce the acidity of the gastric juices, the number of reflux episodes remains unchanged, so the oesophageal mucosa is still exposed to the action of the gastric juices.
  • H2 antihistamines (anti-H2s) and antacids are also used to treat the symptoms of gastroesophageal reflux disease.
  • Despite the availability of various therapeutic approaches, the success rates are much lower if remission and improvement of symptoms are also considered.
  • Up to 40% of GERD patients have poorly controlled symptoms, which indicates that there is still a need for new therapeutic agents to treat the disorder.
  • Moreover, there is known to be a relationship between diet and reflux. For example, it is known that a meal rich in fats increases the symptoms of reflux and the frequency of reflux episodes by reducing the pressure of the lower oesophageal sphincter. The relationship between other constituents of the diet and reflux is less well known.
  • It has been demonstrated that the administration of lactose to volunteers increases acid reflux episodes and markedly influences the function of the lower oesophageal sphincter. The effects of lactose are mediated by the production of short-chain fatty acids, which derive from the metabolism of lactose by the bacterial flora of the colon (Piche et al., 2000; Am J Physiol Gastrointest Liver Physiol 278: G578-84).
  • The administration of fructo-oligosaccharides (FOS) also induces effects on the pressure of the lower oesophageal sphincter and the pH of the oesophageal lumen similar to those observed with lactose administration (Piche et al., Gastroenterology 2003; 124: 894-902).
  • These data suggest that fermentation in the colon of wholly or partly unabsorbed carbohydrates may be responsible for the onset or aggravation of gastroesophageal reflux disease.
  • A preliminary study (9 cases - methodologically elegant and placebo-controlled) has demonstrated that a preparation based on alpha-galactosidase acts as reflux inhibitor (Grossi et al., Digestive and Liver Disease 41S: FISMAD Milan, 28/3-1/4 2009; S49 - Abstract).
  • In that study, the administration of alpha-galactosidase for 4 weeks reduced the frequency of Transient Lower Oesophageal Sphincter Relaxations (TLES relaxation), reflux episodes, the percentage of pH < 4 and the severity of the reflux symptoms.
  • As the disorder is so widespread, there is still a need to use alternative compositions for the prevention and/or treatment of gastroesophageal reflux disease.
    • Summary of the invention
  • The present invention relates to pharmaceutical or nutritional compositions containing α-galactosidase and β-galactosidase.
  • The invention also relates to the use of said compositions in the prevention and/or treatment of gastroesophageal reflux disease.
    • Description of the invention
  • The present invention relates to pharmaceutical or nutritional compositions containing α-galactosidase and β-galactosidase as active ingredients.
  • It has now surprisingly been found that pharmaceutical or nutritional compositions containing α-galactosidase and β-galactosidase are useful in the prevention and/or treatment of gastroesophageal reflux disease (GERD). Said compositions have a different action mechanism from those of the medicaments currently used (acid secretion inhibitors) in that they inhibit reflux or at least reduce its frequency.
  • The present invention represents a new therapeutic strategy, which is designed in particular for non-responders and patients with a poor response to the current treatments based on proton pump inhibitors.
  • The pharmaceutical or nutritional compositions to which the present invention relates can be also added to the existing treatments (as an "add-on therapy"), leading to a significant improvement in the quality of life of many patients with gastroesophageal reflux disease.
  • The present invention relates to pharmaceutical or nutritional compositions containing a combination of the active ingredients, mixed with at least one pharmaceutically acceptable excipient or carrier.
  • Said compositions are preferably administered orally.
  • The pharmaceutical or nutritional compositions for the prevention and/or treatment of gastroesophageal reflux disease containing α-galactosidase and β-galactosidase as active ingredients can be formulated by conventional methods.
  • The preferable dosage forms are solid formulations for oral administration, such as powders, granules, tablets, pills and capsules.
  • When these compositions are prepared, the active ingredients can be mixed with at least one pharmaceutically acceptable excipient or carrier, such as an inert diluent, a lubricant such as magnesium stearate, an anti-caking agent such silicon dioxide, a preservative, an antioxidant, a disintegrant, a binder, a thickening agent, a buffer, a sweetener such as acesulfame potassium, a flavouring agent, etc..
  • Further dosage forms can be liquid formulations for oral administration including, for example, emulsions, syrups, elixirs, suspensions and solutions.
  • The dose of the active ingredients for each patient is determined on the basis of age, body weight, general state of health, gender, diet, condition of the disease treated and/or other factors.
  • The quantity of the active ingredients in the composition can range from 75 GalU to 2400 GalU for α-galactosidase, preferably from 300 GalU to 1200 GalU, and most preferably amounts to 300 GalU in the form of dosage units, and from 2500 to 12500 LactU for β-galactosidase, preferably from 3500 to 11000 LactU, and most preferably amounts to 4500 LactU in the form of dosage units.
  • The dosage unit form is usually administered one or more times a day, as required.
  • α-Galactosidase has proved to prevent the onset of bloating and flatulence symptoms after intake of Non-digestible Oligosaccharides (NDOs) and to reduce the intensity of heartburn and the frequency of regurgitation episodes during repeated administration to patients with gastroesophageal reflux disease.
  • The combination of α-galactosidase and β-galactosidase has provided an unexpected symptomatic benefit in some patients, who respond unsatisfactory to conventional therapy based on PPI. There is initial evidence that the combination of the two substances boosts the effects by reducing the frequency and duration of reflux to an extent which is markedly high.
  • The examples given below further illustrate the invention.
    • Examples Formulation example 1
  • The composition according to the invention in the form of a tablet to be swallowed or chewed contains:
    • 69 mg β-galactosidase (65000 LactU/g)
    • 30 mg α-galactosidase (10000 GalU/g)
    • 280 mg sorbitol
    • 22.78 mg flavouring
    • 8 mg crosslinked sodium carboxymethylcellulose
    • 8 mg magnesium stearate
    • 2 mg silicon dioxide
    • 0.22 mg acesulfame potassium
    Formulation example 2
  • The composition according to the invention in the form of a tablet to be swallowed contains:
    • 69 mg β-galactosidase (65000 LactU/g)
    • 30 mg α-galactosidase (10000 GalU/g)
    • 280 mg sorbitol
    • 8 mg crosslinked sodium carboxymethylcellulose
    • 8 mg magnesium stearate
    • 2 mg silicon dioxide
    • 30 mg ginger (Zingiber officinale) extract

Claims (2)

  1. Pharmaceutical or nutritional compositions containing α-galactosidase and β-galactosidase, wherein the content of α-galactosidase ranges from 75 and 2400 GaIU and the content of β-galactosidase ranges from 2500 to 12500 LactU, in the form of a dosage unit and at least one pharmaceutically acceptable excipients or carrier.
  2. Pharmaceutical or nutritional composition according to claim 1 for use in the prevention and /or treatment of gastroesophageal reflux disease.
EP12172907.3A 2011-06-24 2012-06-21 Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease Active EP2537528B1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
MEP-2015-159A ME02285B (en) 2011-06-24 2012-06-21 Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease
PL12172907T PL2537528T3 (en) 2011-06-24 2012-06-21 Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease
SI201230335T SI2537528T1 (en) 2011-06-24 2012-06-21 Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease
HRP20151082TT HRP20151082T1 (en) 2011-06-24 2015-10-13 Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
IT001154A ITMI20111154A1 (en) 2011-06-24 2011-06-24 PHARMACEUTICAL OR NUTRITIONAL COMPOSITIONS INCLUDING GALACTOSIDASE AND THEIR USE

Publications (2)

Publication Number Publication Date
EP2537528A1 EP2537528A1 (en) 2012-12-26
EP2537528B1 true EP2537528B1 (en) 2015-09-16

Family

ID=44534538

Family Applications (1)

Application Number Title Priority Date Filing Date
EP12172907.3A Active EP2537528B1 (en) 2011-06-24 2012-06-21 Pharmaceutical compositions containing beta- and alpha-galactosidase and their use in the treatment of gastroesophageal reflux disease

Country Status (11)

Country Link
EP (1) EP2537528B1 (en)
DK (1) DK2537528T3 (en)
ES (1) ES2548546T3 (en)
HR (1) HRP20151082T1 (en)
HU (1) HUE025669T2 (en)
IT (1) ITMI20111154A1 (en)
ME (1) ME02285B (en)
PL (1) PL2537528T3 (en)
PT (1) PT2537528E (en)
RS (1) RS54325B1 (en)
SI (1) SI2537528T1 (en)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9402885B2 (en) * 2013-07-15 2016-08-02 Alfa Wassermann S.P.A. Method of treating GERD with alpha and beta galactosidases

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0176971A3 (en) * 1984-09-29 1987-12-02 Wakamoto Pharmaceutical Co., Ltd. Gene coding for thermostable beta-galactosidase, bacillus subtilis having the gene, enzyme coded by the gene and a process for the production thereof
NZ233582A (en) * 1989-05-16 1992-05-26 Akpharma Inc Formerly Aek Dev Oral composition comprising alpha-galactosidase
DE202006012340U1 (en) * 2006-08-10 2007-09-20 Maria Clementine Martin Klosterfrau Vertriebsgesellschaft Mbh Pharmaceutical composition, in particular for use in food intolerances

Also Published As

Publication number Publication date
PT2537528E (en) 2015-11-02
DK2537528T3 (en) 2015-10-26
RS54325B1 (en) 2016-02-29
SI2537528T1 (en) 2015-12-31
HRP20151082T1 (en) 2015-12-04
HUE025669T2 (en) 2016-05-30
PL2537528T3 (en) 2015-12-31
ITMI20111154A1 (en) 2012-12-25
EP2537528A1 (en) 2012-12-26
ES2548546T3 (en) 2015-10-19
ME02285B (en) 2016-02-20

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